Fungal Peritonitis Pada Pasien Dengan Continuous Ambulatory Peritoneal Dialysis

Fungal peritonitis hanya terjadi pada 3-6% kasus dialysis-related peritonitis namun angka mortalitasnya sangat tinggi. Gambaran klinis tidak spesifik sehingga sulit dibedakan dengan peritonitis bacterial. Analisis dan biakan cairan dialisat berperan penting sebagai pedoman terapi antimikroba.Laki-laki berusia 22 tahun menjalaniCAPD selama 10 tahun, datang ke RS dengan nyeri Perut berat pada saat inflow dan outflow cairan. Pada pemeriksaan analisis cairan didapatkan makroskopis kuning keruh, hitung leukosit 2.580 sel/L dengan PMN sebanyak 90%, dan kadar protein total 1.0mg/dL. Pada pemeriksaan biakan ditemukan Candida Tropicalis.Pemeriksaan analisis cairan dialisat peritoneal belum lazim dilakukan dan sampai saat ini belum terdapat nilai rujukan. Pada pasien ini dijumpai cairan keruh, jumlah leukosit lebih dari 100 sel/L dengan dominasi PMN, serta biakan positif, sehingga memenuhi kriteria diagnosis fungal peritonitis menurut International Society of Peritoneal Dialysis tahun 2009. Pada pasien ini dijumpai kadar protein total 1,0g/dL. Dalam keadaan normal, caira dialisat tidak mengandung protein. Adanya peritonitis menyebabkan pembukaan pori besar pada membrane peritoneum sehingga terjadi kobocoran makromolekul.Analisis caira dialisat penting dilakukan pada kecurigaan infeksi. Diagnosis fungal peritonitis dapat ditegakkan melalui pemeriksaan analisis cairan serta dipastikan melalui pemeriksaan biakan

Optical properties of bialkali photocathodes

The optical properties of the `bialkali' KCsSb and RbCsSb photomultiplier cathodes have been experimentally investigated in the visible range. The measurements carried out include the absolute reflectance at near-normal incidence, the polarization-dependent relative reflectance at various angles and the change in polarization upon reflection from the photocathode. These experimental inputs have been combined with a theoretical model to determine the complex refractive index of the photocathodes in the wavelength range 380 to 680 nm and their thickness. As a result of this work, we derive a model which predicts the fraction of light impinging on a photomultiplier tube that is reflected, absorbed or transmitted, as a function of wavelength and angle, and dependent on the medium to which the photomultiplier is coupled.Comment: 51 pages (double spacing), 16 figures, submitted for publication in NIM

Super-resolution, Extremal Functions and the Condition Number of Vandermonde Matrices

Super-resolution is a fundamental task in imaging, where the goal is to extract fine-grained structure from coarse-grained measurements. Here we are interested in a popular mathematical abstraction of this problem that has been widely studied in the statistics, signal processing and machine learning communities. We exactly resolve the threshold at which noisy super-resolution is possible. In particular, we establish a sharp phase transition for the relationship between the cutoff frequency ($m$) and the separation ($\Delta$). If $m > 1/\Delta + 1$, our estimator converges to the true values at an inverse polynomial rate in terms of the magnitude of the noise. And when $m < (1-\epsilon) /\Delta$ no estimator can distinguish between a particular pair of $\Delta$-separated signals even if the magnitude of the noise is exponentially small. Our results involve making novel connections between {\em extremal functions} and the spectral properties of Vandermonde matrices. We establish a sharp phase transition for their condition number which in turn allows us to give the first noise tolerance bounds for the matrix pencil method. Moreover we show that our methods can be interpreted as giving preconditioners for Vandermonde matrices, and we use this observation to design faster algorithms for super-resolution. We believe that these ideas may have other applications in designing faster algorithms for other basic tasks in signal processing.Comment: 19 page

Monte Carlo simulations of the solid-liquid transition in hard spheres and colloid-polymer mixtures

Monte Carlo simulations at constant pressure are performed to study coexistence and interfacial properties of the liquid-solid transition in hard spheres and in colloid-polymer mixtures. The latter system is described as a one-component Asakura-Oosawa (AO) model where the polymer's degrees of freedom are incorporated via an attractive part in the effective potential for the colloid-colloid interactions. For the considered AO model, the polymer reservoir packing fraction is eta_p^r=0.1 and the colloid-polymer size ratio is q=sigma_p/\sigma=0.15 (with sigma_p and sigma the diameter of polymers and colloids, respectively). Inhomogeneous solid-liquid systems are prepared by placing the solid fcc phase in the middle of a rectangular simulation box creating two interfaces with the adjoined bulk liquid. By analyzing the growth of the crystalline region at various pressures and for different system sizes, the coexistence pressure p_co is obtained, yielding p_co=11.576 k_BT/sigma^3 for the hard sphere system and p_co=8.0 k_BT/sigma^3 for the AO model (with k_B the Boltzmann constant and T the temperature). Several order parameters are introduced to distinguish between solid and liquid phases and to describe the interfacial properties. From the capillary-wave broadening of the solid-liquid interface, the interfacial stiffness is obtained for the (100) crystalline plane, giving the values gamma=0.49 k_BT/sigma^2 for the hard-sphere system and gamma=0.95 k_BT/sigma^2 for the AO model.Comment: 11 pages, 13 figure

Why Are Alkali Halide Solid Surfaces Not Wetted By Their Own Melt?

Alkali halide (100) crystal surfaces are anomalous, being very poorly wetted by their own melt at the triple point. We present extensive simulations for NaCl, followed by calculations of the solid-vapor, solid-liquid, and liquid-vapor free energies showing that solid NaCl(100) is a nonmelting surface, and that its full behavior can quantitatively be accounted for within a simple Born-Meyer-Huggins-Fumi-Tosi model potential. The incomplete wetting is traced to the conspiracy of three factors: surface anharmonicities stabilizing the solid surface; a large density jump causing bad liquid-solid adhesion; incipient NaCl molecular correlations destabilizing the liquid surface. The latter is pursued in detail, and it is shown that surface short-range charge order acts to raise the surface tension because incipient NaCl molecular formation anomalously reduces the surface entropy of liquid NaCl much below that of solid NaCl(100).Comment: 4 pages, 3 figure

Pengukuran Komponen Zat Besi pada Laki-Laki Pendonor Darah Rutin di Kabupaten Gunung Kidul Tahun 2013

Iron deficiency is one of the most common nutritional disorder in the world and this can happen in the routine male blood donors. In people who donate blood on a regular basis are feared to iron deficiency without anemia. Thus a major concern of the donor screening for iron deficiency aiming for blood donors is to stay healthy and continue to donate blood. This study used a cross-sectional design in the male blood donors from Gunung Kidul who donate blood first, fifth and tenth times. Each donation made up of 25 people who were taken blood samples for serum iron (SI), total iron binding capacity (TIBC), transferrin saturation and serum ferritin examination. Results obtained in the first donation, the mean ferritin level was 91.78; the fifth donation increased ferritin levels in the amount of 111.49 and decreased again in the tenth donation donor group 65.28. Results of Kruskal Wallis test showed no significant difference between the mean ferritin levels in the first donation, the fifth and the tenth time (p=0.044). There is a decrease in body iron stores (serum ferritin) in the tenth donation while no changes for SI, TIBC and transferrin saturation. The more often one donate blood can cause first stage of iron deficiency which call as iron depletion. Therefore need to be considered dietary or nutritional status and also supplements provided after donor.Keywords : blood donor, iron status, Gunung KidulAbstrakDefisiensi besi adalah salah satu gangguan gizi yang paling umum dan bisa terjadi pada para pendonor darah laki-laki yang rutin. Pada pendonor darah yang sering mendonorkan darah, pada suatu waktu dikhawatirkan dapat terjadi defisiensi besi tanpa anemia. Tujuan dari penelitian adalah untuk mendapatkan hubungan kekerapan donasi dengan penurunan cadangan besi tubuh (feritin serum) dan saturasi besi. Penelitian ini menggunakan desain potong lintang pada para pendonor darah laki-laki di Gunung Kidul yang menyumbangkan darahnya pertama, kelima dan kesepuluh kali. Jumlah donor dari kelompok donasi sebanyak 25 orang yang diambil sampel darahnya untuk dilakukan pemeriksaan serum iron (SI), total iron binding capacity (TIBC), saturasi transferin dan feritin serum. Didapatkan hasil pada kelompok pendonor pertama kali, rerata kadar feritin adalah 91,78; pada kelompok pendonor yang menyumbangkan darahnya kelima kali terjadi peningkatan kadar feritin yaitu sebesar 111,49 dan menurun lagi pada kelompok pendonor donasi yang menyumbangkan darahnya kesepuluh kali yakni 65,28. Hasil uji kruskal wallis menunjukkan ada perbedaan rerata yang bermakna antara kadar feritin dari donasi pertama, kelima dan kesepuluh kali (nilai p=0,044). Kadar SI, TIBC dan saturasi transferin tidak mengalami Perubahan sedangkan cadangan besi tubuh (feritin serum) pada donasi kesepuluh mengalami penurunan. Semakin sering seseorang menyumbangkan darah dapat terjadi defisiensi besi tahap pertama yang disebut juga iron depletion.Kata kunci : donor darah, status zat besi, Gunung Kidu

Antibiotic Associated Diarrhea in Hospitalized Adult Patients

Background: Antibiotic associated diarrhea (AAD) occurs from the first initiation until 2 months of the end of antibiotic treatment. The aims of this study were to know the incidence of AAD, Clostridium difficile infection and other gastrointestinal symptoms in hospitalized adult patients.Method: The study is a cross sectional study. We studied the antibiotic associated diarrhea (AAD), Clostridium difficile infection and other gastrointestinal symptoms in patients who were admited in Cipto Mangunkusumo Hospital. Inclusion were male or female, age 18-75 years old, Patients started receiving antibiotics maximal 2 x 24 hours prior to hospitalization, gave written informed consent.Results: The incidence of AAD was 11.5%. The incidence of Clostridium difficile infection was 15.4%. The Upper gastrointestinal symptom was present on 20 (38.5%) patients. Lower abdominal symptom was present on 10 (19.2%) patients.Conclusion: The Incidence of AAD and Clostridium difficile infection were 11.5% and 15.4% respectively. The clinical manifestations of AAD were diarrhea, other upper and lower abdominal symptoms

Function and Platelet Count in Thrombocyte Concentrate (TC) During the Storage

Background: Evaluation for platelet transfusion is not optimal for this moment even in upstream at theblood center or in downstream at the hospital. The purpose of this study was to determine the effect ofstorage time to changes in pH, platelet count and function that occurs on platelet aggregation duringdifferent time storage.Methods: The study design was cross-sectional on selected bags of platelet concentrates that have passedthe screening for infection transmitted through blood transfusions. The regular assessment in UTDD forPC has been done every month by random sampling with three parameters pH, platelets count and volumein the bag of blood. The testing for pH, platelet count, and aggregation functions for 50 samples with threedifferent test time were conducted on day 0, third day, and fifth day storage.Results: On 50 bags samples, pH, and number of platelets increased, but the platelet aggregation functiondecreased on the third day of storage. On the fifth day of storage the pH, number of platelets and theplatelets aggregation function decreased and found the lowest number almost in all samples.Conclusion: The three parameters: pH, platelet counts, and aggregation functions decreased on the fifthday of storage. (Health Science Journal of Indonesia;2015;6:48-51

The Role of a Novel Digital Microcapillary Instrument in Detecting Blood and Plasma Hyperviscosity

Aim: to test the precision and accuracy of a Digital Microcapillary instrument in measuring blood and plasma viscosity. Methods: about 40 blood samples were drawn for precision test. The samples were obtained from patients admitted for Medical Check-Up at CiptoMangunkusumo Hospital (RSCM) in December 2011. Accuracy test was evaluated using cross-sectional design and involving 135 patients with acute ischemic stroke. The patients underwent either inpatients or outpatients care at Department of Clinical Pathology, Department of Neurology,and Emergency Unit of RSCM, Fatmawati Hospital Jakarta, Prikasih Hospital Jakarta, and Bhakti Yuda Hospital Depok. The precision test was evaluated by calculating the coefficient of variation (CV), interrater variability of Cronbach Alpha, and reliability coefficient of Bland Altman. The accuracy of the test was evaluated with a diagnostic test. The gold standard used for these tests was Brookfield LV-DV III viscometer. Results: the results of precision test were: CV = 0.04; interrater variability of blood and plasma viscosity = 0.94 and 0.82, respectively; the Bland Altman mean difference = –0.19. The results of accuracy test were: sensitivity of blood and plasma viscosity measurement were 88.9% and 100%, respectively; specificity of blood and plasma viscosity measurement were 88.9% and 84%, respectively. Conclusion: the digital microcapillary has high sensitivity and specificity; therefore the instrument can be considered to be used as screening test tool to measure blood and plasma viscosity. Key words: digital microcapillary, blood viscosity, plasma viscosity, acute ischemic strok

Cardiac Performance by Echocardiography, Cardiovascular Biomarker, Kidney Function, and Venous Oxygen Saturation as Mortality Predictors of Septic Shock

Background: cardiac function in patients with septic shock at the cellular level can be assessed by measuring troponin I and NT Pro BNP levels. Venous oxygen saturation is measured to evaluate oxygen delivery and uptake by organ tissue. Our study may provide greater knowledge and understanding on pathophysiology of cardiovascular disorder in patients with septic shock. This study aimed to evaluate the roles of echocardiography, cardiovascular biomarkers, venous oxygen saturation and renal function as predictors of mortality rate in patients with septic shock. Methods: this is a prospective cohort study in patients with infections, hypotension (MAP 2 mmol/L. On the first and fifth days, septic patients underwent echocardiography and blood tests. Statistical analysis used in our study included t-test or Mann-Whitney test for numeric data and chi-square test for nominal data of two-variable groups; while for multivariate analysis, we used Cox Regression model. Results: on 10 days of observation, we found 64 (58%) patients died and 47 (42%) patients survived. The mean age of patients was 48 (SD 18) years. Patients with abnormal left ventricular ejection fraction (LVEF) had 1.6 times greater risk of mortality than those with normal LVEF (RR 1.6; p = 0.034). Patients with abnormal troponin I level showed higher risk of mortality as many as 1.6 times (RR: 1.6; p = 0.004). Patients with impaired renal function had 1.5 times risk of mortality (RR 1.5; p = 0.024). Patients with abnormal troponin I level and/or impaired renal function showed increased mortality risk; however, those with normal troponin I level and impaired renal function also showed increased mortality risk. Multivariate analysis revealed that left ventricular ejection fraction and troponin I level may serve as predictors of mortality in patients with septic shock. (HR 1.99; 95% CI: 1.099  ̶  3.956 ; p = 0.047 and HR: 1.83 ; 95%CI: 1.049  ̶ 3,215 ; p = 0.043). Conclusion: left ventricular ejection fraction and biomarkers such as troponin I level are predictors of mortality in septic shock patients